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 Mom had a scary fall. 
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Mom had a scary fall.
Yesterday morning my mom tried to get up by herself, tripped, and slammed her face onto the edge of the table before falling to the floor. She had to be taken by ambulance to the ER where we learned she'd broken her nose. Since then she's slept most of the time and has barely eaten. She fell asleep DURING both breakfast and lunch after just a few bites today and didn't want dinner. Although she has a prescription for Vicoden, it took until this evening to get it to the facility where she's living. Other than the tablet she got at the ER in the early afternoon yesterday, she's only been on Tylenol until tonight, so sleepiness from medication shouldn't be the issue. Does anyone have experience with this? Is her response normal and temporary, or is this a new baseline? Is it the beginning of the end? It's hard to know what to expect and how to support my dad.


Wed Nov 23, 2011 12:10 am
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Mom had a scary fall.
It's so hard to know if your mom will bounce back or not. I think you'll have a better idea in a week or so.

What a nasty fall. Does she have a bed alarm? Can your family afford to have someone sit with her to be sure she doesn't get up on her own? What about adding bed rails such that she can't get out of bed on her own?


Wed Nov 23, 2011 2:09 am
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Mom had a scary fall.
That must have been a terrifying experience for both your mother and your poor dad!

I think you might begin to help your dad prepare for the possibility that this is a permanent decline. But also be aware that the immediate reaction to a trauma or a disease may improve during and after recovery. It is possible -- but not certain -- that she'll return to her former baseline. It can take a long time, though (in our experience).

Will she be going to a rehab place when she is discharged, or is it too early to tell?

Hugs to you all.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Wed Nov 23, 2011 3:36 am
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Re: Mom had a scary fall.
She actually was in the common area when this occurred. She had been sitting in a chair when another resident was walking and became teetery so both caregivers present went to her aid. While they were helping that woman, Mom tried to stand up and fell. She rarely tries to stand or walk independently anymore, so they weren't expecting it and actually didn't even see her get up because both were focused on the other resident. It was just a very unfortunate accident. We don't blame the facility at all. She was discharged the same day from the hospital--just an ER visit. Today my dad and I took her to her regular doctor for a follow-up visit. She really isn't able to walk anymore. We used a wheelchair, and we had a heck of a time helping her with the toilet and getting into and out of the car. She could provide some assistance before the fall, but now she's dead weight. Her legs won't cooperate anymore at all. She closed her eyes when the nurse was taking her blood pressure, and a few minutes later when the doctor was trying to look in her eyes, we had a hard time getting her to open them. She didn't get pain medicine this morning, so she was truly out of it and not just drugged up. She hardly ate anything again today at breakfast or lunch. I'm afraid that this is the new normal, but I guess there's no way to know yet. Time will tell.

As for her bed, she does have an alarm on it. Also, the mattress is on the floor, and we put a body pillow alongside her, and the other side of the bed is against the wall. She has fallen out of it only once since moving to the facility in early September, and that was within the first week or two. I don't think she's been able to swing her legs around to the side of the bed independently for awhile, so I don't think she tries to get up from bed herself anymore.


Wed Nov 23, 2011 6:49 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Mom had a scary fall.
I'm so sorry to read this.

What did the MD say as to your mom's prognosis?


Wed Nov 23, 2011 7:37 pm
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Joined: Wed Dec 30, 2009 1:46 pm
Posts: 3213
Location: WA
Post Re: Mom had a scary fall.
My husband has an alarm under his w/c pad, too. He has fallen six or seven times since being there but, thankfully, has sustained no injuries other than a few scrapes. Since he is unable to stand it hasn't happened lately.

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Pat [68] married to Derek [84] for 38 years; husband dx PDD/LBD 2005, probably began 2002 or earlier; late stage and in a SNF as of January 2011. Hospitalized 11/2/2013 and discharged to home Hospice. Passed away at home on 11/9/2013.


Wed Nov 23, 2011 8:42 pm
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Re: Mom had a scary fall.
The MD didn't really say anything about her prognosis in regards to the fall. I mentioned she wasn't eating, and the doctor just said that she wouldn't be hungry after a fall like that, either. As for her overall prognosis, her neurologist told me in August that at her rate of decline, she'd likely die within a year, two at the most.

We have an appointment next week at the hospital to have her evaluated for a wheelchair. I'm not sure why she needs to be evaluated for it. The doctor kind of rolled her eyes today when she heard how much difficulty my dad has had getting a wheelchair for her because of all the red tape he has to go through. He's been trying for 2 months now. She said, "I gave an order for it. I don't understand why it's taking so long." I'm beginning to suspect that my dad either isn't hearing people or understanding the process because that does seem excessively long. Meanwhile, her assisted living facility has provided a temporary one. I think her days of trying to stand on her own are over now. I don't think her body will cooperate. If she does try again, though, I think we need to ask about an alarm for her wheelchair.


Wed Nov 23, 2011 9:58 pm
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Joined: Sun Oct 17, 2010 2:06 am
Posts: 63
Post Re: Mom had a scary fall.
I'm so sorry for what you (we) are going through. My hb has had several ER visits for faints and very short seizures. Each visit, full of trauma and scary sticks and procedures, seems to have been bad for him. He comes home exhausted, sleeps intermittently for several days, and never quite regains his previous baseline. I don't know if it's the actual event, the faint or whatever, or if it's the ER, but we've determined not to take him again unless other symptoms are present. They always send him home after about 8 hrs, having done nothing but monitor him. The last time the dr as much as asked why we were putting my hb through this useless ordeal. I agree, and we won't do it again.
So my experience is that ER visits are hard on Lewy patients, and it will take several recovery days before you can say what your mom's post-injury situation will be.


Fri Nov 25, 2011 2:44 am
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Joined: Wed Sep 30, 2009 8:25 am
Posts: 227
Post Re: Mom had a scary fall.
I have to agree with Challenged. We used to take her to the ER, but the experience was more traumatic than the fall. Now someone follows my MIL around to make sure she uses walker and to break a fall in case she faints or has a seizure. Luckily she lives with me so I can make sure this happens. She has had a couple of episodes but we were able to circumvent serious injury. She doesn't like it, but I tell her that if she falls and breaks something she might have to go to a rehab facility. Since this is her biggest fear, this usually works. I tell the daytime caregivers that if my MIL can help herself get up, then it's OK. But if she cannot help herself up, they must call the paramedics to come evaluate the situation. So far, so good.

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Donna (age 56) caregiver for mother-in-law Margaret (age 88).


Fri Nov 25, 2011 10:55 am
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Re: Mom had a scary fall.
In my mom's case, the care facility had called an ambulance, and we met her at the ER. There was a lot of blood, and after hitting her face on the table, she fell to the floor hand-first, so there was some concern whether she'd broken her wrist as well. I'd read on this site that ER visits were not a great idea for Lewy patients, but I'm not sure in this case it could have been any different. At the ER they did a CT scan, cleaned and bandaged her, gave her pain medication, and sent her on her way. It took about 2 hours, mostly waiting for results of the CT scan. I was grateful because the nurses noticed she had a wet Depends on and so very discreetly and gently changed her before sending her home. They could have pretended they didn't notice, so I was impressed. It's been five days now, and she still hasn't bounced back entirely, but she was able to take a few steps last night, so that's a slight improvement. She's only eating if someone feeds her, though, and her eyes are mostly closed, so it's almost like she's eating in her sleep. She's also slept through some meals since this happened, when before she'd always wake up for them.


Sat Nov 26, 2011 7:27 pm
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Joined: Fri Dec 31, 2010 3:07 pm
Posts: 1039
Location: Minnesota
Post Re: Mom had a scary fall.
Five days is not enough time to see where this is going to end up. Prepare for decline, but hope for returning to baseline.

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Jeanne, 68 cared for husband Coy, 86. RBD for 30+ years; LDB since 2003, Coy at home, in early stage, until death in 2012


Sat Nov 26, 2011 8:30 pm
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Joined: Mon Feb 21, 2011 9:55 pm
Posts: 355
Post Re: Mom had a scary fall.
Try not to worry. This has happened to my Dad so many times I have lost count. He went downhill so fast after several UTI's, slept all the time, lost his appetite. and was extremely confused. This even happened him when the staff gave him a shower (he had only been getting bed baths before). It only takes a very simple thing to set our loved ones back, and a serious fall like your poor Mom had is bound to take a lot out of her. If she has taken some steps I would take that as a good sign. Good luck and keep us updated,
Ger xxx

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cared for Dad who passed away on January 28th 2013 R.I.P.


Sat Nov 26, 2011 9:16 pm
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Joined: Tue Dec 29, 2009 2:28 pm
Posts: 464
Location: Minnesota
Post Re: Mom had a scary fall.
As Ger said, try not to worry. It does sound like quite a fall and is bound to have her down for some time. Even a healthy person would need some time to recover from one like that.

I'm glad she's in a wheelchair. It shouldn't take so long, though, for her own. Does her facility have an occupational therapist? Mom got one pretty much tailored to her when she left a rehab facility, courtesy of Medicare and her supplemental insurance. It was arranged by the OT. Your dad shouldn't have to be looking for one. An occupational therapist should be setting out specific requirements and measurements for the chair and then following through on getting the right one.

A lot of the residents at Mom's SNF try to get up on their own. Thankfully, Mom doesn't. One thing we family members (of all of the residents) have started doing is looking around the room when we are with our LO and, when someone we know shouldn't be standing up tries to anyway, we'll say something like "Lois sit down!" The staff can't provide one on one assistance or monitoring, so family members just started helping by either reminding residents to sit down or by making sure a staff member is aware of the situation. I think it has cut down on a lot of falls.

Most of Mom's falls are out of bed. She's always been an active sleeper and I think she just isn't adjusting to the smaller bed in the SNF. I watched her once and first one leg slides off the bed, then another, then her bottom starts going over and gravity handles the rest. The staff lowers her bed as far as is possible and there is a thick mat placed next to it. So she seldom gets hurt. Once I suggested to the nurse that they just throw a quilt over her and let her sleep on the mat. She couldn't fall off of that! And they are trying a new mattress this week. It kind of looks like a skateboard park, with a slope toward the center on each side. We'll see if that helps.

Kate

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Kate [i](Cared for Mom for years before anyone else noticed the symptoms, but the last year of her life was rough and we needed to place her in an SNF, where she passed in February 2012)[/i]


Mon Nov 28, 2011 3:12 pm
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Joined: Fri May 28, 2010 4:46 pm
Posts: 119
Location: Salem, Oregon
Post Re: Mom had a scary fall.
My mom saw an occupational therapist at the hospital today and was fitted for a walker and wheelchair since she's kind of in an in-between stage. Some days she definitely needs the wheelchair, but she did well with the walker today. We were able to take the speficiations to a medical supply place today and already have them for her.

Ironically, my mom used to be nurse manager at the hospital we visited today. The receptionist and a couple of the older nurses and therapists knew her still. One nurse she used to work with is a nurse at her care facility now. They have done a good job of hiding their shock when they see her, but she was a well-loved boss, and their sadness comes through. It was hard to tell if she even recognized where she was. We were on a different floor than where she had her office, so maybe not. She didn't seem to recognize any of the people who knew her, but it has been at least 7 years since she's worked there.


Wed Nov 30, 2011 7:35 pm
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Joined: Fri Aug 11, 2006 1:46 pm
Posts: 4811
Location: SF Bay Area (Northern CA)
Post Re: Mom had a scary fall.
How sad for you and the people who knew your mom. It sounds like she was unaware, which is a blessing.


Wed Nov 30, 2011 8:14 pm
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